Medical Specialties > Interventional Radiology > Critical Limb Ischaemia

Critical Limb Ischaemia (CLI / CLTI)

Critical limb ischaemia (CLI), also known as chronic limb-threatening ischaemia (CLTI)* represents the most advanced state of peripheral artery disease (PAD) and manifests as rest pain, non-healing ulcers, and/or gangrene.

  • More than 10% of patients with PAD may develop CLI.1
  • 56% of patients hospitalised with CLI are readmitted within ~1 year2

Patients aged ≥ 50 years who are diagnosed with CLI at initial clinical presentation have a 25% risk of death after one year and a 30% chance of amputation.3,4

cli pad population
This poor prognosis is also linked to multiple co-morbidities which result in a low quality of life for these patients.
This complex disease requires increased awareness, more effective therapies, and strong collaboration of all stakeholders in patient care, for improved outcomes.
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Multidisciplinary approach

CLI is a complex disease which involves numerous interactions between the patient and a variety of healthcare providers. Improvement in patient outcomes would at best be incremental without close communication between stakeholders at each step of the patient pathway. 

Diagnosis and Referral

Diagnosis and Referral

 Symptoms related to CLI can often be overlooked by both patients and physicians. Early recognition of symptoms in at-risk populations and rapid referral is key to achieving the primary goal of limb salvage as CLI can progress quickly.

Treatment

Treatment

Treatment of patients with CLI has advanced significantly in recent years with the development of technical skills and improvements in technology. However, there still remains a gap in both skills and technology required to successfully revascularize the small and calcified vessels below the knee that are common in CLI patients.  

Patient monitoring

Patient monitoring

Close follow up and monitoring of CLI patients is required following revascularisation to verify the impact of treatment on disease progression. Follow up may include medical therapy management, wound care, and monitoring vessel patency.

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* The term 'chronic limb-threatening ischaemia' (CLTI) is used with the aim of acknowledging the full spectrum of conditions beyond ischaemia that contribute to the poor outcomes linked to this disease.

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